Paranoia is the oxygen of a suspense story. Think of all those great films — most of them made by Hitchcock — built around the premise of a main character questioning his or her own gut instincts: Suspicion, Gaslight, Shadow of a Doubt, Rebecca. While it's always satisfying to see that basic premise of self-doubt in suspense endlessly resurrected, it's downright spine-tingling to encounter the work of a new writer who has managed to ring brilliant changes on that classic formula.
Turn of Mind is a debut novel by Alice LaPlante billed as a "literary thriller": that it sure is. The main character here is Dr. Jennifer White. She's 64 years old and retired from her practice as an orthopedic surgeon in Chicago. Her old friend down the block, a woman named Amanda with whom she's shared good times as well as a lot of emotional friction, has just been found dead in her house, murdered. What's especially gruesome about Amanda's murder is the fact that four of her fingers were surgically removed after she was killed. Did I mention that Dr. Jennifer White's specialty as a surgeon was hands? And that the two women were heard arguing the night of the murder? The solution to this crime should be simple to grasp, so to speak, except for one problem. Dr. White has been diagnosed with dementia. She simply can't remember whether or not she murdered her friend. Most days she doesn't even remember that her friend is dead.
This is a "can't fail" premise that any moderately competent suspense writer could spin an entertaining novel out of; but, what bumps Turn of Mind up into the exalted Daphne du Maurier/Ruth Rendell category of "literary thriller" is LaPlante's fearless and compassionate investigation into the erosion of her main character's mind. Here's how Dr. White herself, in one of her more lucid moments, describes her own deterioration:
"This half state. Life in the shadows. As the neurofibrillary tangles proliferate, as the neuritic plaques harden, as synapses cease to fire and my mind rots out, I remain aware. An unanesthetized patient."
Turn of Mind reads as a series of fragmentary-but-illuminating first-person conversations between Dr. White and various other characters — some of them living (like Dr. White's caregiver, her concerned adult daughter and her shiftless son); some of them dead (like the murder victim herself). In the short space of these dialogues, Dr. White's grip on reality fades in and out like an iffy radio frequency, and time frames collapse into each other with fluid ease. We readers become so (nervously) at home in the haunted house of Dr. White's head that when she describes her disorientation one night in trying to find her way out of what we think is her locked bedroom and her subsequent decision to just squat down on the rug and pee, well, it makes perfect off-kilter sense. Black humor even wafts into this nightmare every so often. Early on, Dr. White attends an Alzheimer's support group. The leader, a young social worker, refers to the group as being guided by "Two Circular Steps." Step One [he tells the attendees] is admitting you have a problem. Step Two is forgetting you have the problem. But, all jokes stop when Dr. White, in conversation with a police detective, obligingly opens a piano bench stuffed with junk and shows the detective where she has buried her surgical scalpel — the one that's most suitable for amputating fingers.
LaPlante's turn on the suspense formula is especially ingenious because, as anxious-but-enthralled readers, we have to agree to be entrapped inside Dr. White's crumbling mind for the duration: We're, thus, dependent on this most undependable of characters to (perhaps) exonerate herself as an ultimate deadline of complete mental oblivion looms. If this were a straight work of literary fiction, that grim storyline might be too hard to stick with; but, that's where the suspense formula rescues this tale from despair. Just as we're losing Dr. White, we readers are rewarded with the cold comfort of the truth about the murder. Forgetfulness, it turns out, may be something of a mercy after all.